Chapter 16. Registered Nurse — Workers' Compensation Medical Case Manager
Regulation .01 Exclusion from Regulations.LinkCopy Citation
This chapter is not applicable to, and does not restrict or limit, a:
A.
Registered nurse from performing those functions which constitute the practice of registered nursing as defined by law; and
B.
Medical claims consultant from performing medical claims consultation as defined in this chapter.
Regulation .02 Definitions.LinkCopy Citation
A.
In this chapter, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
“Board” means the Board of Nursing.
(2)
“Board-approved course” means an educational offering specific to the case management of the injured worker under the Workers' Compensation Commission which meets the criteria established by the Board.
(3)
“Commission” means the Workers' Compensation Commission.
(4)
Medical Case Management.
(a)
“Medical case management” means any type of contact, including electronic, written, and personal, with the injured worker, for the purpose of the planning and coordination of health services appropriate to achievement of medical rehabilitation of the injured worker.
(b)
“Medical case management” includes but is not limited to:
(i)
Case assessment;
(ii)
Implementation and coordination of services with the injured worker, family, and health care providers;
(iii)
Evaluation of treatment results;
(iv)
Coordinating community re-entry;
(v)
Return to work with the employer of injury; and
(vi)
Referral for further vocational rehabilitation services.
(5)
“Medical claims consultant” means a registered nurse who consults on medical aspects of an injured worker's rehabilitation without any contact with the injured worker.
(6)
“Multistate licensure privilege” has the meaning set forth in COMAR 10.27.01.01B.
(7)
“Registered nurse (RN)” means an individual who:
(a)
Is licensed by the Board to practice registered nursing; or
(b)
Has a multistate licensure privilege to practice registered nursing.
(8)
“RN-WCCM” means a registered nurse-workers' compensation medical case manager.
Regulation .03 Certification Requirements.LinkCopy Citation
A.
For certification as an RN-WCCM, an applicant shall:
(1)
Hold a current license to practice registered nursing in this State or a multistate licensure privilege to practice registered nursing;
(2)
Submit documentation of successful completion of a Board-approved course;
(3)
Submit to the Board a completed application for certification as an RN-WCCM; and
(4)
Pay all fees.
B.
The Board shall include on the RN's license the designation WCCM.
C.
Certification by Endorsement. An applicant from out-of-State shall meet the requirements as stated in this regulation.
Regulation .04 Renewal of Certification.LinkCopy Citation
A.
Unless renewed biennially, a certification to practice as an RN-WCCM expires at the same time as the registered nurse license.
B.
Before certification as an RN-WCCM expires, the RN-WCCM may renew the certification for an additional term, if the RN—WCCM:
(1)
Is otherwise entitled to be certified;
(2)
Has practiced a minimum of 2,000 hours in the past 2 years as an RN—WCCM;
(3)
Submits a completed application for renewal on the form the Board requires; and
(4)
Pays all fees.
C.
If the registered nurse does not meet the practice requirement stated in §B(2) of this regulation, the registered nurse shall complete a Board-approved course to be eligible for renewal of the RN-WCCM certification.
Regulation .05 Notice to Workers' Compensation Commission.LinkCopy Citation
The Board shall:
A.
Notify the Commission of:
(1)
The status of any RN-WCCM regulated under this chapter; and
(2)
Any RN-WCCM who fails to renew their certification; and
B.
Provide the Commission quarterly reports of disciplinary actions taken against any licensee governed by this chapter.
Regulation .06 Scope of Practice.LinkCopy Citation
A.
The RN-WCCM may perform medical case management of the injured worker as defined in this chapter.
B.
The RN-WCCM shall comply with all:
(1)
Other statutes or regulations governing registered nurse practice; and
(2)
Laws, statutory policies, and procedures of the Commission.
C.
The RN-WCCM shall maintain medical records in accordance with Health-General Article, Title 4, Subtitle 4, Annotated Code of Maryland.
Regulation .07 Course Approval.LinkCopy Citation
A.
Each provider shall:
(1)
Submit a course proposal for approval before implementation and at least every 3 years thereafter; and
(2)
Obtain from the Board a curriculum checklist detailing the content to be included in the course.
B.
All changes, additions, or deletions to the course shall be approved by the Board before implementation.
Regulation .08 Course Requirements.LinkCopy Citation
A.
Each course shall have a minimum of 16 hours of theory content.
B.
The curriculum shall include the following content areas:
(1)
An historical perspective of case management;
(2)
Insurance terms and types of coverage—general;
(3)
Federal and State insurance statutes and regulations governing workers' compensation;
(4)
Stakeholders—roles, responsibilities, ethical considerations, and goals;
(5)
Maryland Nurse Practice Act; and
(6)
Case management, including:
(a)
Assessment;
(b)
Planning;
(c)
Implementation;
(d)
Evaluation;
(e)
Written reporting; and
(f)
Communication.
C.
The course offering shall use texts from a Board-approved list.
Regulation .09 Faculty.LinkCopy Citation
A.
Qualifications. Faculty shall hold a:
(1)
Current license in Maryland to practice registered nursing or a multistate licensure privilege to practice registered nursing; and
(2)
Certification as a case manager by a certifying body recognized by the Board.
B.
Responsibilities. Faculty shall:
(1)
Plan, implement, and evaluate the course at periodic planned intervals; and
(2)
Develop and utilize written examinations to measure achievement of course objectives.
Regulation .10 Unlawful Practice.LinkCopy Citation
A.
Unless authorized to practice under this chapter, an individual may not use the words “registered nurse—workers' compensation medical case manager”, RN—WCCM, or any other words, letters, or symbols with the intent to represent that the individual is a registered nurse-workers' compensation medical case manager.
B.
An individual certified under this chapter is subject to disciplinary sanctions set forth in Health Occupations Article, Title 8, Annotated Code of Maryland.
C.
An individual may not practice medical case management for the Commission unless authorized under this chapter.
Chapter annotations
Authority: Health-General Article, §4-403; Health Occupations Article, §§8-102 and 8-205; Annotated Code of Maryland
History: Effective date:
History: Regulations .01—.10 adopted as an emergency provision effective August 2, 1999; adopted permanently effective November 15, 1999 (26:23 Md. R. 1777)
History: Regulation .02B amended effective July 2, 2018 (45:13 Md. R. 667)
History: Regulation .03 amended effective July 2, 2018 (45:13 Md. R. 667)
History: Regulation .04 amended effective July 2, 2018 (45:13 Md. R. 667)
History: Regulation .05A amended effective July 2, 2018 (45:13 Md. R. 667)
History: Regulation .06C adopted effective October 13, 2025 (52:20 Md. R. 1002)
History: Regulation .09A amended effective July 2, 2018 (45:13 Md. R. 667)